Closure at Last on a Long Journey - Maybe

EDITOR’S NOTE – This is the second installment in a two-part series on industry reaction to the U.S. House of Representatives passage of the H.R. 2 bill, from which ICD-10 escaped unscathed.

For many ICD-10 stakeholders, the U.S. Senate’s passage of the Medicare reform bill last Tuesday was a fait accompli.

The heavy lifting had been lifted. Arms had been twisted. Hearings had been heard. Teeth were clenched. Fingers crossed. And there it was, like a newborn baby under parental scrutiny: H.R. 2. H.R.dd

Born March 26. No amendments. No pay cuts to physicians and no delay of ICD-10.

So when the Senate voted overwhelmingly, 92-8, for the $200billion Medicare reform package, it ended the loathsome “doc fix” and also foreclosed any hopes by some of another ICD-10 delay.

Passage of H.R. 2 could have been an exhaustive victory lap were it not for the fact that hospitals, health systems and physician practices, clearinghouses, and payors had been moving ahead doggedly (and, albeit, in some cases, disjointedly) to implement the long-awaited code set. Instead, passage of H.R. 2 arrived almost as an afterthought. The seventh inning stretch. A cup of coffee in the break room. Peeling off single-use rubber gloves.

In what now seems a postmortem, Talk-Ten-Tuesdays asked six major professional organizations for their reaction to passage of H.R. 2, and also to describe where they are with ICD-10 implementation initiatives. They appeared on the March 31 broadcast, a special 60-minute edition. Here are excerpts from members of three of those associations, plus two private industry representatives.

The Workgroup for Electronic Data Interchange (WEDI)

“As most of you are aware, WEDI is a nonpartisan organization representing a cross-section of the healthcare industry and is named in federal law as an advisor to HHS,” Jim Daley, past chairman of WEDI, explained to audience members. “WEDI has been working on ICD-10 for over 15 years to bring attention to this initiative and to help the industry determine how to implement the new code set.”

Daley described how WEDI approached ICD-10 by creating an official ICD-10 work group in 2009. He said they began holding monthly calls to provide updates that are still going on today.

“Many of these discussions result in recommendations for new work products,” said Daley. “WEDI set up sub-work groups to address the different aspects of ICD-10 and published white papers on topics such as the overall implementation process, how to do an impact assessment, and how to use the CMS GEMs (general equivalence mappings).”

Daley said that one of the WEDI tools that would be helpful for providers even today is the WEDI Roadmap Toolkit, which provides links to key resources for each phase of the compliance process; the toolkit is available on the WEDI website, www.wedi.org.

“Currently, we have three sub-work groups dealing with transition, coding and translation, and testing,” Daley said. “Recently published items include a clarification of terminology such as dual coding and dual processing, and a paper on testing for small provider practices.”

Daley also listed other projects that WEDI is creating, including one centering on information regarding DRG shifts and a roadmap with milestones to help providers determine if they have completed certain phases. The latter tool also suggests mitigation measures for any obstacles providers might face along the way.

“We’re also developing a list of top 10 things payors should post on their websites related to ICD-10, and we’re looking to create a consolidated database of industry test results,” Daley said. “WEDI has been conducting ICD-10 readiness surveys since 2009.”

Daley said that according to the most recent readiness survey — the association’s tenth — all industry segments cited the delay as one of the biggest obstacles to being ready for ICD-10.

“WEDI will continue to provide educational opportunities and produce work products as needed through these next several months to assist the industry in final preparations for ICD-10 implementation,” Daley added.